CAJ | 학술논문

目的探讨中国人群尤其是低体重人群中体重指数(BMI)与缺血性心脏病(IHD)死亡之间的关系.方法数据来源于1990-1991年已随访15年共涉及中国220 000名40～79岁男性对象的前瞻性队列研究.利用Cox比例风险模型,在调整年龄、吸烟史及其他潜在混杂因素后,计算BMI与IHD死亡间的相对危险度(解).结果基线BMI平均值为21.7 kg/m~2.15年随访期间,共有2763例对象死于IHD(占总死亡的6.8%).在排除了基线调查时已报告息有心脑血管疾病史的对象后,BMI与IHD死亡率之间呈"J"形关系.当BMI＞20 kg/m~2时,BMI与IHD死亡风险呈正相关.BMI值每升高5 kg/m~2,IHD死亡率相应增高21%(95%CI:9%～35%,P=0.0004).而当BMI＜20kg/m~2时,IHD死亡风险反而随着BMI的下降呈上升的趋势.在BMI值为20～21.9、18～19.9、＜18 kg/m~2范围时,其对应的RR值分别为1.00、1.11和1.14.在排除了前3年随访中死亡的病例或将分析局限于从不吸烟者中,BMI与IHD死亡风险的关系仍呈现相同趋势.结论对于处在所谓正常BMI范围值内(20～25 kg/m~2)的人群,BMI与IHD死亡风险呈正相关,但当BMI低于这一范围,两者的关联极有可能为负相关.
목적 탐토중국인군우기시저체중인군중체중지수(BMI)여결혈성심장병(IHD)사망지간적관계.방법 수거래원우1990-1991년이수방15년공섭급중국220 000명40～79세남성대상적전첨성대렬연구.이용Cox비례풍험모형,재조정년령、흡연사급기타잠재혼잡인소후,계산BMI여IHD사망간적상대위험도(해).결과 기선BMI평균치위21.7 kg/m~2.15년수방기간,공유2763례대상사우IHD(점총사망적6.8%).재배제료기선조사시이보고식유심뇌혈관질병사적대상후,BMI여IHD사망솔지간정"J"형관계.당BMI＞20 kg/m~2시,BMI여IHD사망풍험정정상관.BMI치매승고5 kg/m~2,IHD사망솔상응증고21%(95%CI:9%～35%,P=0.0004).이당BMI＜20kg/m~2시,IHD사망풍험반이수착BMI적하강정상승적추세.재BMI치위20～21.9、18～19.9、＜18 kg/m~2범위시,기대응적RR치분별위1.00、1.11화1.14.재배제료전3년수방중사망적병례혹장분석국한우종불흡연자중,BMI여IHD사망풍험적관계잉정현상동추세.결론 대우처재소위정상BMI범위치내(20～25 kg/m~2)적인군,BMI여IHD사망풍험정정상관,단당BMI저우저일범위,량자적관련겁유가능위부상관.
Objective To assess the relationship between body mass index (BMI) and ischaemic heart disease (IHD) mortality,especially in populations with low mean BMI levels.Methods We examined the data from a population-based,prospective cohort study of 220 000 Chinese men aged 40-79,who were enrolled in 1990-1991,and followed up ever since to 1/1/2006.Relative risks of the deaths from IHD by the baseline BMI were calculated,after controlling age,smoking,and the other potential confounding factors.Results The mean baseline BMI was 21.7 kg/m~2,and 2763 IHD deaths were recorded during the 15-year follow-up (6.8% of all deaths) program.Among men without prior vascular diseases at baseline,there was a J-shaped association between BMI and IHD mortality.When baseline BMI was above 20 kg/m~2,there was a strongly positive association of BMI with IHD risk,with each 5 kg/m~2 higher in BMI associated with 21%(95%CI:9%-35%,P=0.0004) higher IHD mortality.Below this BMI range,the association appeared to be reverse,with the risk ratios as 1.00,1.11,and 1.14,respectively,for men with BMI 20-21.9,18-19.9,and ＜ 18 kg/m~2.The excess IHD risk observed at low BMI levels persisted after restricting analysis to never smokers or excluding the first 3 years of follow-up.Conclusion Lower BMI was associated with lower IHD risk among people in the so-called 'normal range' of BMI values (20-25 kg/m~2).However,below that range,the association might well be reversed.